Clinical impact of calcified nodule in patients with heavily calcified lesions requiring rotational atherectomy
Objectives We sought to evaluate the incidence and clinical impact of calcified nodule (CN) in patients with heavily calcified lesions requiring rotational atherectomy (RA). Background It remains unclear whether CN impacts adversely on clinical outcomes in patients with heavily calcified lesions. Me...
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| Veröffentlicht in: | Catheterization and cardiovascular interventions 2021-01, Vol.97 (1), p.10-19 |
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| container_title | Catheterization and cardiovascular interventions |
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| creator | Morofuji, Toru Kuramitsu, Shoichi Shinozaki, Tomohiro Jinnouchi, Hiroyuki Sonoda, Shinjo Domei, Takenori Hyodo, Makoto Shirai, Shinichi Ando, Kenji |
| description | Objectives
We sought to evaluate the incidence and clinical impact of calcified nodule (CN) in patients with heavily calcified lesions requiring rotational atherectomy (RA).
Background
It remains unclear whether CN impacts adversely on clinical outcomes in patients with heavily calcified lesions.
Methods
Between January 2011 and February 2014, 264 patients after second‐generation drug‐eluting stent (DES) implantation following RA were retrospectively enrolled. CN was defined as a convex shape of the luminal side of calcium as assessed by intravascular ultrasound. The primary endpoint was the cumulative 5‐year incidence of major adverse cardiac events (MACE), defined as a composite of cardiac death, clinically driven target lesion revascularization (CDTLR), and definite stent thrombosis (ST).
Results
CN was observed in 128 patients (48.5%) with heavily calcified lesions. Cumulative 5‐year incidence of MACE was significantly higher in the CN group than in the non‐CN group, mainly driven by a higher rate of CDTLR and ST (35.4% vs. 18.8%, p |
| doi_str_mv | 10.1002/ccd.28896 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_journals_2478480064</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2478480064</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3536-f6c9e392894447ece69aa8d5668d8951e2aeb8bc28d73321c0feb8699fbe384d3</originalsourceid><addsrcrecordid>eNp1kE1LxDAQhoMo7rp68A9IwJOH7qZpmyZHqZ8geFHwVtJ06mZpm27SuvTfG-0qXjzNvPDMw_AidB6SZUgIXSlVLinngh2geZhQGqSUvR3u91DEbIZOnNsQQgSj4hjNIkoTEQk6RyardauVrLFuOql6bCrsk9KVhhK3phxqwLrFnew1tL3DO92v8Rrkh67HP2QNTpvWYQvbQVvdvmNren9jWq-W_RosqN404yk6qmTt4Gw_F-j17vYlewienu8fs-unQEVJxIKKKQH-QS7iOE5BARNS8jJhjJdcJCFQCQUvFOVlGkU0VKTymQlRFRDxuIwW6HLydtZsB3B9vjGD9c-4nMYpjzkhLPbU1UQpa5yzUOWd1Y20Yx6S_Kva3Febf1fr2Yu9cSgaKH_Jny49sJqAna5h_N-UZ9nNpPwEPJqEyQ</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2478480064</pqid></control><display><type>article</type><title>Clinical impact of calcified nodule in patients with heavily calcified lesions requiring rotational atherectomy</title><source>Wiley Online Library - AutoHoldings Journals</source><creator>Morofuji, Toru ; Kuramitsu, Shoichi ; Shinozaki, Tomohiro ; Jinnouchi, Hiroyuki ; Sonoda, Shinjo ; Domei, Takenori ; Hyodo, Makoto ; Shirai, Shinichi ; Ando, Kenji</creator><creatorcontrib>Morofuji, Toru ; Kuramitsu, Shoichi ; Shinozaki, Tomohiro ; Jinnouchi, Hiroyuki ; Sonoda, Shinjo ; Domei, Takenori ; Hyodo, Makoto ; Shirai, Shinichi ; Ando, Kenji</creatorcontrib><description>Objectives
We sought to evaluate the incidence and clinical impact of calcified nodule (CN) in patients with heavily calcified lesions requiring rotational atherectomy (RA).
Background
It remains unclear whether CN impacts adversely on clinical outcomes in patients with heavily calcified lesions.
Methods
Between January 2011 and February 2014, 264 patients after second‐generation drug‐eluting stent (DES) implantation following RA were retrospectively enrolled. CN was defined as a convex shape of the luminal side of calcium as assessed by intravascular ultrasound. The primary endpoint was the cumulative 5‐year incidence of major adverse cardiac events (MACE), defined as a composite of cardiac death, clinically driven target lesion revascularization (CDTLR), and definite stent thrombosis (ST).
Results
CN was observed in 128 patients (48.5%) with heavily calcified lesions. Cumulative 5‐year incidence of MACE was significantly higher in the CN group than in the non‐CN group, mainly driven by a higher rate of CDTLR and ST (35.4% vs. 18.8%, p < .001; 23.2% vs. 7.9%, p < .001; 7.0% vs. 0.93%, p = .009, respectively). Independent risk factors of 5‐year MACE included hemodialysis (hazard ratio [HR] = 3.39, 95% confidence intervals [CI]: 2.00–5.73, p < .001), CN (HR = 2.53, 95% CI: 1.49–4.27, p < .001), ostial lesion (HR = 3.02, 95% CI: 1.58–5.78, p = .001), left ventricular ejection fraction ≤40% (HR = 2.17, 95% CI: 1.27–3.70, p = .005), and right coronary artery lesion (HR = 1.82, 95% CI: 1.07–3.11, p = .03).
Conclusions
CN was observed in 48.5% of heavily calcified lesions, resulting in unfavorable long‐term clinical outcomes after second‐generation DES implantation following RA.</description><identifier>ISSN: 1522-1946</identifier><identifier>EISSN: 1522-726X</identifier><identifier>DOI: 10.1002/ccd.28896</identifier><identifier>PMID: 32259392</identifier><language>eng</language><publisher>Hoboken, USA: John Wiley & Sons, Inc</publisher><subject>Calcification ; calcified nodule ; Calcium ; Clinical outcomes ; Coronary artery ; drug‐eluting stent ; Heart ; Hemodialysis ; Implants ; Lesions ; percutaneous coronary intervention ; Risk factors ; rotational atherectomy ; Stents ; Thrombosis ; Ultrasound ; Ventricle</subject><ispartof>Catheterization and cardiovascular interventions, 2021-01, Vol.97 (1), p.10-19</ispartof><rights>2020 Wiley Periodicals, Inc.</rights><rights>2021 Wiley Periodicals LLC.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3536-f6c9e392894447ece69aa8d5668d8951e2aeb8bc28d73321c0feb8699fbe384d3</citedby><cites>FETCH-LOGICAL-c3536-f6c9e392894447ece69aa8d5668d8951e2aeb8bc28d73321c0feb8699fbe384d3</cites><orcidid>0000-0001-5607-9051 ; 0000-0001-9927-9686</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fccd.28896$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fccd.28896$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32259392$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Morofuji, Toru</creatorcontrib><creatorcontrib>Kuramitsu, Shoichi</creatorcontrib><creatorcontrib>Shinozaki, Tomohiro</creatorcontrib><creatorcontrib>Jinnouchi, Hiroyuki</creatorcontrib><creatorcontrib>Sonoda, Shinjo</creatorcontrib><creatorcontrib>Domei, Takenori</creatorcontrib><creatorcontrib>Hyodo, Makoto</creatorcontrib><creatorcontrib>Shirai, Shinichi</creatorcontrib><creatorcontrib>Ando, Kenji</creatorcontrib><title>Clinical impact of calcified nodule in patients with heavily calcified lesions requiring rotational atherectomy</title><title>Catheterization and cardiovascular interventions</title><addtitle>Catheter Cardiovasc Interv</addtitle><description>Objectives
We sought to evaluate the incidence and clinical impact of calcified nodule (CN) in patients with heavily calcified lesions requiring rotational atherectomy (RA).
Background
It remains unclear whether CN impacts adversely on clinical outcomes in patients with heavily calcified lesions.
Methods
Between January 2011 and February 2014, 264 patients after second‐generation drug‐eluting stent (DES) implantation following RA were retrospectively enrolled. CN was defined as a convex shape of the luminal side of calcium as assessed by intravascular ultrasound. The primary endpoint was the cumulative 5‐year incidence of major adverse cardiac events (MACE), defined as a composite of cardiac death, clinically driven target lesion revascularization (CDTLR), and definite stent thrombosis (ST).
Results
CN was observed in 128 patients (48.5%) with heavily calcified lesions. Cumulative 5‐year incidence of MACE was significantly higher in the CN group than in the non‐CN group, mainly driven by a higher rate of CDTLR and ST (35.4% vs. 18.8%, p < .001; 23.2% vs. 7.9%, p < .001; 7.0% vs. 0.93%, p = .009, respectively). Independent risk factors of 5‐year MACE included hemodialysis (hazard ratio [HR] = 3.39, 95% confidence intervals [CI]: 2.00–5.73, p < .001), CN (HR = 2.53, 95% CI: 1.49–4.27, p < .001), ostial lesion (HR = 3.02, 95% CI: 1.58–5.78, p = .001), left ventricular ejection fraction ≤40% (HR = 2.17, 95% CI: 1.27–3.70, p = .005), and right coronary artery lesion (HR = 1.82, 95% CI: 1.07–3.11, p = .03).
Conclusions
CN was observed in 48.5% of heavily calcified lesions, resulting in unfavorable long‐term clinical outcomes after second‐generation DES implantation following RA.</description><subject>Calcification</subject><subject>calcified nodule</subject><subject>Calcium</subject><subject>Clinical outcomes</subject><subject>Coronary artery</subject><subject>drug‐eluting stent</subject><subject>Heart</subject><subject>Hemodialysis</subject><subject>Implants</subject><subject>Lesions</subject><subject>percutaneous coronary intervention</subject><subject>Risk factors</subject><subject>rotational atherectomy</subject><subject>Stents</subject><subject>Thrombosis</subject><subject>Ultrasound</subject><subject>Ventricle</subject><issn>1522-1946</issn><issn>1522-726X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><recordid>eNp1kE1LxDAQhoMo7rp68A9IwJOH7qZpmyZHqZ8geFHwVtJ06mZpm27SuvTfG-0qXjzNvPDMw_AidB6SZUgIXSlVLinngh2geZhQGqSUvR3u91DEbIZOnNsQQgSj4hjNIkoTEQk6RyardauVrLFuOql6bCrsk9KVhhK3phxqwLrFnew1tL3DO92v8Rrkh67HP2QNTpvWYQvbQVvdvmNren9jWq-W_RosqN404yk6qmTt4Gw_F-j17vYlewienu8fs-unQEVJxIKKKQH-QS7iOE5BARNS8jJhjJdcJCFQCQUvFOVlGkU0VKTymQlRFRDxuIwW6HLydtZsB3B9vjGD9c-4nMYpjzkhLPbU1UQpa5yzUOWd1Y20Yx6S_Kva3Febf1fr2Yu9cSgaKH_Jny49sJqAna5h_N-UZ9nNpPwEPJqEyQ</recordid><startdate>20210101</startdate><enddate>20210101</enddate><creator>Morofuji, Toru</creator><creator>Kuramitsu, Shoichi</creator><creator>Shinozaki, Tomohiro</creator><creator>Jinnouchi, Hiroyuki</creator><creator>Sonoda, Shinjo</creator><creator>Domei, Takenori</creator><creator>Hyodo, Makoto</creator><creator>Shirai, Shinichi</creator><creator>Ando, Kenji</creator><general>John Wiley & Sons, Inc</general><general>Wiley Subscription Services, Inc</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>7U9</scope><scope>H94</scope><scope>K9.</scope><orcidid>https://orcid.org/0000-0001-5607-9051</orcidid><orcidid>https://orcid.org/0000-0001-9927-9686</orcidid></search><sort><creationdate>20210101</creationdate><title>Clinical impact of calcified nodule in patients with heavily calcified lesions requiring rotational atherectomy</title><author>Morofuji, Toru ; Kuramitsu, Shoichi ; Shinozaki, Tomohiro ; Jinnouchi, Hiroyuki ; Sonoda, Shinjo ; Domei, Takenori ; Hyodo, Makoto ; Shirai, Shinichi ; Ando, Kenji</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3536-f6c9e392894447ece69aa8d5668d8951e2aeb8bc28d73321c0feb8699fbe384d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Calcification</topic><topic>calcified nodule</topic><topic>Calcium</topic><topic>Clinical outcomes</topic><topic>Coronary artery</topic><topic>drug‐eluting stent</topic><topic>Heart</topic><topic>Hemodialysis</topic><topic>Implants</topic><topic>Lesions</topic><topic>percutaneous coronary intervention</topic><topic>Risk factors</topic><topic>rotational atherectomy</topic><topic>Stents</topic><topic>Thrombosis</topic><topic>Ultrasound</topic><topic>Ventricle</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Morofuji, Toru</creatorcontrib><creatorcontrib>Kuramitsu, Shoichi</creatorcontrib><creatorcontrib>Shinozaki, Tomohiro</creatorcontrib><creatorcontrib>Jinnouchi, Hiroyuki</creatorcontrib><creatorcontrib>Sonoda, Shinjo</creatorcontrib><creatorcontrib>Domei, Takenori</creatorcontrib><creatorcontrib>Hyodo, Makoto</creatorcontrib><creatorcontrib>Shirai, Shinichi</creatorcontrib><creatorcontrib>Ando, Kenji</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><jtitle>Catheterization and cardiovascular interventions</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Morofuji, Toru</au><au>Kuramitsu, Shoichi</au><au>Shinozaki, Tomohiro</au><au>Jinnouchi, Hiroyuki</au><au>Sonoda, Shinjo</au><au>Domei, Takenori</au><au>Hyodo, Makoto</au><au>Shirai, Shinichi</au><au>Ando, Kenji</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Clinical impact of calcified nodule in patients with heavily calcified lesions requiring rotational atherectomy</atitle><jtitle>Catheterization and cardiovascular interventions</jtitle><addtitle>Catheter Cardiovasc Interv</addtitle><date>2021-01-01</date><risdate>2021</risdate><volume>97</volume><issue>1</issue><spage>10</spage><epage>19</epage><pages>10-19</pages><issn>1522-1946</issn><eissn>1522-726X</eissn><abstract>Objectives
We sought to evaluate the incidence and clinical impact of calcified nodule (CN) in patients with heavily calcified lesions requiring rotational atherectomy (RA).
Background
It remains unclear whether CN impacts adversely on clinical outcomes in patients with heavily calcified lesions.
Methods
Between January 2011 and February 2014, 264 patients after second‐generation drug‐eluting stent (DES) implantation following RA were retrospectively enrolled. CN was defined as a convex shape of the luminal side of calcium as assessed by intravascular ultrasound. The primary endpoint was the cumulative 5‐year incidence of major adverse cardiac events (MACE), defined as a composite of cardiac death, clinically driven target lesion revascularization (CDTLR), and definite stent thrombosis (ST).
Results
CN was observed in 128 patients (48.5%) with heavily calcified lesions. Cumulative 5‐year incidence of MACE was significantly higher in the CN group than in the non‐CN group, mainly driven by a higher rate of CDTLR and ST (35.4% vs. 18.8%, p < .001; 23.2% vs. 7.9%, p < .001; 7.0% vs. 0.93%, p = .009, respectively). Independent risk factors of 5‐year MACE included hemodialysis (hazard ratio [HR] = 3.39, 95% confidence intervals [CI]: 2.00–5.73, p < .001), CN (HR = 2.53, 95% CI: 1.49–4.27, p < .001), ostial lesion (HR = 3.02, 95% CI: 1.58–5.78, p = .001), left ventricular ejection fraction ≤40% (HR = 2.17, 95% CI: 1.27–3.70, p = .005), and right coronary artery lesion (HR = 1.82, 95% CI: 1.07–3.11, p = .03).
Conclusions
CN was observed in 48.5% of heavily calcified lesions, resulting in unfavorable long‐term clinical outcomes after second‐generation DES implantation following RA.</abstract><cop>Hoboken, USA</cop><pub>John Wiley & Sons, Inc</pub><pmid>32259392</pmid><doi>10.1002/ccd.28896</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0001-5607-9051</orcidid><orcidid>https://orcid.org/0000-0001-9927-9686</orcidid></addata></record> |
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| source | Wiley Online Library - AutoHoldings Journals |
| subjects | Calcification calcified nodule Calcium Clinical outcomes Coronary artery drug‐eluting stent Heart Hemodialysis Implants Lesions percutaneous coronary intervention Risk factors rotational atherectomy Stents Thrombosis Ultrasound Ventricle |
| title | Clinical impact of calcified nodule in patients with heavily calcified lesions requiring rotational atherectomy |
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